Research in context
Evidence before this study
We searched PubMed, Embase, MEDLINE, and Google Scholar for articles published from inception up to Sept 1, 2019, using an array of search terms including “benchmarking”, “surgical utilization”, “surgical demand”, and “optimal utilization”, with no language restrictions, and no other empirical work on benchmarking use of cancer surgery was found. Similar benchmarking has been previously done for chemotherapy and radiotherapy, and the models have been applied to improve service provision.
Added value of this study
The population-level benchmark for use of cancer surgery in high-income settings is currently unknown. We therefore adapted the work on chemotherapy and radiotherapy use to produce, to the best of our knowledge, the first guideline-based empirical estimate of the proportion of patients with an indication for surgery anytime during the treatment of their cancer. Demand estimates and resource predictions have previously been based on real-world practice and therefore influenced by many supply-side limitations. Our estimate of the benchmark for the use of cancer surgery provides a superior alternative for planning future cancer surgical services. The derived benchmarks can be compared with observed surgery rates at a population level to measure variations in the provision of cancer surgery and to plan for future requirements.
Implications of all the available evidence
This model and the overall evidence produced would generate a framework for estimating current and future demand for cancer surgical services, as well as to plan for future cancer surgical services based on evidence.